Provider Demographics
NPI:1982617437
Name:COLLINS SURGICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:COLLINS SURGICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KANDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:CPC CPPM
Authorized Official - Phone:860-522-1024
Mailing Address - Street 1:290 COLLINS ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1549
Mailing Address - Country:US
Mailing Address - Phone:860-522-1024
Mailing Address - Fax:860-278-4613
Practice Address - Street 1:300 HEBRON AVE STE 211
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2192
Practice Address - Country:US
Practice Address - Phone:860-522-1024
Practice Address - Fax:860-278-4613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC00537Medicare PIN